Serum Ferritin in Patients With Cirrhosis is Associated With Markers of Liver Insufficiency and Circulatory Dysfunction, but Not of Portal Hypertension. Issue 9 (October 2015)

• Record Type: Journal Article
• Authors: Ripoll, Cristina; Keitel, Felix; Hollenbach, Marcus; Greinert, Robin; Zipprich, Alexander
• Is Part Of: Journal of clinical gastroenterology. Volume 49:Issue 9(2015)
• Publication Date: 2015-10
• Subjects: ferritin -- cirrhosis -- iron overload -- portal hypertension -- liver insufficiency; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Digestive organs -- Diseases; Gastroenterology; Periodicals; Periodicals; 616.33005
• DOI: 10.1097/MCG.0000000000000283
• Languages: English
• ISSNs: 0192-0790

Abstract

Abstract : Background/Aims: Iron overload is an increasingly recognized phenomenon in nonhemochromatosis cirrhosis. To evaluate the relationship between iron overload and liver insufficiency and portal hypertension. Patients and Methods: Cirrhotics with hepatic hemodynamic and ferritin measurement (within 30 d) were included. Exclusion criteria were malignancy (except hepatocellular carcinoma Milan-in), severe chronic obstructive pulmonary disease, acute events in the previous 2 weeks, immunosuppression, transjugular intrahepatic portosystemic shunt or portal vein thrombosis, and end-stage renal disease. Patients were followed-up until death or liver transplant. Univariate and multivariate analysis were used. Results: Fifty-one patients were included (male 61%; median age 57 y; interquartile range, 47 to 66 y); Child-Pugh A 11/B 25/C 15). A positive correlation was observed between ferritin and markers of inflammation (C-reactive protein: r =0.273, P =0.06 and aspartate aminotransferase: r =0.302, P =0.035). No correlation between ferritin and hepatic venous pressure gradient was seen. Negative correlations were observed between ferritin and circulatory dysfunction (mean arterial pressure: r =−0.360, P =0.014 and serum sodium: r =−0.419, P =0.002). In contrast, associations to markers of liver failure such as international normalized ratio ( r =0.333, P =0.005), bilirubin ( r =0.378, P =0.007), albumin ( r =−0.265, P =0.082), model for end-stage liver disease ( r =0.293, P =0.041), and Child-Pugh score ( r =0.392, P =0.009) were observed. No differences in survival according to ferritin was detected. Conclusions: In patients with cirrhosis, serum ferritin levels are associated with markers of liver insufficiency, inflammation, and circulatory dysfunction but not portal hypertension.